TY - JOUR AB - Vaginal intraepithelial neoplasia (VAIN) is a rare disease associated with human papillomavirus infection. High‑grade VAIN is typically treated with either excisional or ablative therapy. However, recurrent VAIN lesions are common and these treatments cause vaginal scarring. Recent studies have indicated that 5% imiquimod is an effective treatment for VAIN. The present report describes a case of a woman diagnosed with recurrent VAIN 3 who was treated with a 5% topical imiquimod cream and achieved a complete response after excision and CO2 laser vaporization. A 53‑year‑old, gravida 5, para 2 postmenopausal woman who was diagnosed with papillary squamous cell carcinoma by biopsy underwent conization, total abdominal hysterectomy and bilateral salpingo‑oophorectomy. A histological examination revealed grade 3 cervical intraepithelial neoplasia with free surgical margins. At 3 years after the hysterectomy, the vaginal smear revealed atypical squamous cells, leading to a pathological diagnosis of VAIN 3. Partial vaginectomy was performed, and VAIN 3 was detected in the lesion with positive margins. At 4 months into follow‑up, the vaginal smear revealed a high‑grade squamous intraepithelial lesion (HSIL), and subsequent biopsy during colposcopy revealed a pathological diagnosis of VAIN 3. At 3 months after CO2 laser vaporization, the vaginal smear revealed HSIL with suspected recurrence and imiquimod treatment was initiated. One sachet of 5% imiquimod cream (0.25 g) was placed in the entire vagina three times per week for 14 weeks with no apparent complications. At 3 years after the treatment, there has been no recurrence. This case demonstrated that topical imiquimod with careful follow‑up is an effective treatment for VAIN and is well‑tolerated. Further clinical evidence of the effectiveness and safety of imiquimod in patients diagnosed with VAIN is required. AD - Department of Obstetrics and Gynecology, Shizuoka General Hospital, Shizuoka 420‑8527, Japan Department of Pathology, Shizuoka General Hospital, Shizuoka 420‑8527, Japan AU - Sasagasako,Nanayo AU - Kosaka,Kenzo AU - Sagae,Yusuke AU - Itoh,Kunitoshi AU - Aratake,Junichi AU - Yamada,Kaori AU - Inayama,Yoshihide AU - Gou,Rei AU - Kawamura,Atsuko AU - Yamanishi,Megumi AU - Yamanishi,Yukio AU - Suzuki,Makoto AU - Arai,Kazumori DA - 2020/09/01 DO - 10.3892/mco.2020.2089 IS - 3 JO - Mol Clin Oncol KW - vaginal intraepithelial neoplasia imiquimod non‑surgical treatment recurrence side effects PY - 2020 SN - 2049-9450 2049-9469 SP - 19 ST - Recurrent vaginal intraepithelial neoplasia successfully treated with topical imiquimod: A case report T2 - Molecular and Clinical Oncology TI - Recurrent vaginal intraepithelial neoplasia successfully treated with topical imiquimod: A case report UR - https://doi.org/10.3892/mco.2020.2089 VL - 13 ER -